A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications

Haddad, Fatma; Dokmak, Ghadeer; Bader, Maryam

doi:10.3390/life13041012

Cited by 17 publications

(6 citation statements)

References 222 publications

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“…In the absence of contraindications, metformin has traditionally been considered as the first-line medication in T2DM patients; however, it promotes modest weight reduction [ 4 , 5 ]. Conversely, the invasive bariatric surgery has been the primary approach to treat severely obese individuals.…”

Section: Introductionmentioning

confidence: 99%

Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset

et al. 2023

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Recent media reports commented about a possible issue of the misuse of antidiabetics related to molecules promoted as a weight-loss treatment in non-obese people. We evaluated here available pharmacovigilance misuse/abuse signals related to semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, in comparison to other GLP-1 receptor agonists (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and tirzepatide) and the phentermine–topiramate combination. To acheieve that aim, we analyzed the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) dataset, performing a descriptive analysis of adverse event reports (AERs) and calculating related pharmacovigilance measures, including the reporting odds ratio (ROR) and the proportional reporting ratio (PRR). During January 2018–December 2022, a total of 31,542 AERs involving the selected molecules were submitted to FAERS; most involved dulaglutide (n = 11,858; 37.6%) and semaglutide (n = 8249; 26.1%). In comparing semaglutide vs. the remaining molecules, the respective PRR values of the AERs ‘drug abuse’, ‘drug withdrawal syndrome’, ‘prescription drug used without a prescription’, and ‘intentional product use issue’ were 4.05, 4.05, 3.60, and 1.80 (all < 0.01). The same comparisons of semaglutide vs. the phentermine–topiramate combination were not associated with any significant differences. To the best of our knowledge, this is the first study documenting the misuse/abuse potential of semaglutide in comparison with other GLP1 analogues and the phentermine–topiramate combination. The current findings will need to be confirmed by further empirical investigations to fully understand the safety profile of those molecules.

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Section: Introductionmentioning

confidence: 99%

Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset

et al. 2023

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“…Both GLP‐1 RA and DPP‐4i enhance the activity of the incretin hormone GLP‐1, but GLP‐1 RAs exhibit a broad impact due to their more potent and sustained GLP‐1 receptor activation 26 . Notably, GLP‐1 RA induce greater weight loss compared to DPP‐4i and maybe the effect of weight loss and glycemic regulation in the early stages of the treatment (6 months following GLP‐1 RA or DPP‐4i) is associated with a long‐term preventive effect.…”

Section: Discussionmentioning

confidence: 99%

Glucagon‐like‐peptide‐1 receptor agonists versus dipeptidyl peptidase‐4 inhibitors and cardiovascular outcomes in diabetes in relation to achieved glycemic control. A Danish nationwide study

Zareini,

Sørensen,

Pedersen‐Bjergaard

et al. 2024

Journal of Diabetes

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AimTo compare the cardiovascular preventive effect associated with glucagon‐like‐peptide‐1 receptor agonists (GLP‐1 RA) versus dipeptidyl peptidase‐4 inhibitors (DPP‐4i) according to the achieved target level of glycated hemoglobin (HbA1c).MethodsWe used retrospective Danish registries to include type 2 diabetes patients already in metformin treatment initiating GLP‐1 RA or DPP‐4i between 2007 and 2021. Patients were included 6 months after GLP‐1 RA or DPP‐4i initiation. The last available HbA1c measurement before inclusion was collected. The achieved HbA1c level was categorized according to a target level below or above 53 mmol/mol (7%). The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, and all‐cause death. We used a multivariable Cox proportional hazard model to estimate the effect of HbA1c levels on the outcome among GLP‐1 RA users compared to DPP‐4i users.ResultsThe study included 13 634 GLP‐1 RA users (median age 56.9, interquartile range [IQR]: 48.5–65.5; 53% males) and 39 839 DPP‐4i users (median age 63.4, IQR: 54.6–71.8; 61% males). The number of GLP‐1 RA and DPP‐4i users according to achieved HbA1c levels were as follows: HbA1c ≤ 53 mmol/mol (≤7.0%): 3026 (22%) versus 4824 (12%); HbA1c > 53 mmol/mol (>7.0%): 6577 (48%) versus 17 508 (44%); missing HbA1c: 4031 (30%) versus 17 507 (44%). During a median follow‐up of 5 years (IQR: 2.6–5.0), 954 GLP‐1 RA users experienced the primary outcome compared to 7093 DPP‐4i users. The 5‐year risk (95% confidence interval [CI]) of the outcome associated with GLP1‐RA versus DPP‐4i according to HbA1c categories was as follows: HbA1c ≤ 53 mmol/mol: 10.3% (8.2–12.3) versus 24.3% (22.7–25.8); HbA1c > 53 mmol/mol: 16.0% (14.3–17.6) versus 21.1% (20.3–21.9); missing HbA1c: 17.1% (15.7–18.5) versus 25.6% (24.9–26.3). The preventive effect associated with GLP‐1 RA versus DPP‐4i was significantly enhanced when achieving lower HbA1c levels: HbA1c ≤ 53 mmol/mol: 0.65 (0.52–0.80); HbA1c > 53 mmol/mol: 0.92 (0.83–1.03); missing HbA1c: 0.92 (0.84–1.02) (p value for interaction <.001).ConclusionGLP‐1 RA use was associated with a lower rate of major adverse cardiovascular outcomes. The association was stronger in patients achieving the target glycemic level and weaker in patients not achieving the target glycemic level, suggestive of an interaction between achieved HbA1c level and GLP‐1 RA.image

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“…The use of antidiabetic drugs, such as metformin, glyburide, and SGLT-2 inhibitors, has shown promising results in terms of promoting weight loss, which has garnered considerable attention ( 72 ). Additionally, disulfiram, a medication commonly prescribed for chronic alcoholism, has demonstrated a significant capability to counteract obesity in rats ( 73 ). Although the specific mechanisms by which these drugs facilitate weight loss are still being investigated, their potential as treatments for obesity should not be underestimated.…”

Section: Challenges In Diabetes Endeavormentioning

confidence: 99%

The dark side of drug repurposing. From clinical trial challenges to antimicrobial resistance: analysis based on three major fields

Natsheh,

Alsaleh,

Alkhawaldeh

et al. 2024

dti

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Drug repurposing is a strategic endeavor that entails the identification of novel therapeutic applications for pharmaceuticals that are already available in the market. Despite the advantageous nature of implement- ing this particular strategy owing to its cost-effectiveness and efficiency in reducing the time required for the drug discovery process, it is essential to bear in mind that there are various factors that must be meticulously considered and taken into account. Up to this point, there has been a noticeable absence of comprehensive analyses that shed light on the limitations of repurposing drugs. The primary aim of this review is to con- duct a thorough illustration of the various challenges that arise when contemplating drug repurposing from a clinical perspective in three major fields cardiovascular, cancer and diabetes and to further underscore the potential risks associated with the emergence of antimicrobial resistance when employing repurposed antibiotics for the treatment of noninfectious and infectious diseases. The process of developing repurposed medications necessitates the application of creativity and innovation in designing the development program, as the body of evidence may differ for each specific case. In order to effectively repurpose drugs, it is crucial to consider the clinical implications and potential drawbacks that may arise during this process. By com- prehensively analyzing these challenges, we can attain a deeper comprehension of the intricacies involved in drug repurposing, which will ultimately lead to the development of more efficacious and safe therapeutic approaches.

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A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications

Cited by 17 publications

References 222 publications

Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset

Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset

Glucagon‐like‐peptide‐1 receptor agonists versus dipeptidyl peptidase‐4 inhibitors and cardiovascular outcomes in diabetes in relation to achieved glycemic control. A Danish nationwide study

The dark side of drug repurposing. From clinical trial challenges to antimicrobial resistance: analysis based on three major fields

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